CAJ | 학술논문

目的：探讨儿童肺部病变的临床病理特征。方法对215例肺部病变的临床表现、影像学、组织形态及免疫组织化学染色等进行分析并复习相关文献。结果215例肺部病变儿童年龄大小刚出生至13岁，平均年龄27.2个月，中位年龄18.0个月。男137例，女78例，男女比为1.76∶1.00。＜1岁组肺先天性病变发病率高于≥1岁组，两组差异具有统计学意义（ P＝0.004）。215例肺部病变中获得性病变142例，先天性肺支气管发育异常相关病变73例。肺脓肿的发病率最高，见于86例患儿（40.0％），其中真菌性肺脓肿1例；其次为先天性肺气道畸形（ CPAM ）44例（20.5％），其中1型20例，2型18例，4型6例；肺隔离症25例（11.6％），叶内型14例，叶外型11例；叶外型肺隔离症中有2例合并CPAM2型；肺结核13例（6.0％）；肺气肿改变12例（5.6％）；间质性肺炎7例（3.2％）；肺出血6例（2.8％）；支气管源性囊肿4例（1.9％）；闭塞性毛细支气管炎2例（0.9％）；肺特发性含铁血黄素沉积症2例（0.9％）；肺非特异性改变1例；肿瘤性病变共13例（6.0％），其中原发性肿瘤共11例（5.1％），包括炎症性肌纤维母细胞肿瘤5例（2.3％）、胸膜肺母细胞瘤5例（Ⅰ型1例，Ⅱ型2例，Ⅲ型2例）、黏液表皮样癌1例（0.5％）；转移性肿瘤共2例（0.9％），其中肝母细胞瘤及肾母细胞瘤转移各1例。结论儿童肺部病变以感染性病变为主；小于1岁婴幼儿则以先天性肺支气管发育异常为主；恶性病变发病率低，但须注意与良性病变相鉴别。
목적：탐토인동폐부병변적림상병리특정。방법대215례폐부병변적림상표현、영상학、조직형태급면역조직화학염색등진행분석병복습상관문헌。결과215례폐부병변인동년령대소강출생지13세，평균년령27.2개월，중위년령18.0개월。남137례，녀78례，남녀비위1.76∶1.00。＜1세조폐선천성병변발병솔고우≥1세조，량조차이구유통계학의의（ P＝0.004）。215례폐부병변중획득성병변142례，선천성폐지기관발육이상상관병변73례。폐농종적발병솔최고，견우86례환인（40.0％），기중진균성폐농종1례；기차위선천성폐기도기형（ CPAM ）44례（20.5％），기중1형20례，2형18례，4형6례；폐격리증25례（11.6％），협내형14례，협외형11례；협외형폐격리증중유2례합병CPAM2형；폐결핵13례（6.0％）；폐기종개변12례（5.6％）；간질성폐염7례（3.2％）；폐출혈6례（2.8％）；지기관원성낭종4례（1.9％）；폐새성모세지기관염2례（0.9％）；폐특발성함철혈황소침적증2례（0.9％）；폐비특이성개변1례；종류성병변공13례（6.0％），기중원발성종류공11례（5.1％），포괄염증성기섬유모세포종류5례（2.3％）、흉막폐모세포류5례（Ⅰ형1례，Ⅱ형2례，Ⅲ형2례）、점액표피양암1례（0.5％）；전이성종류공2례（0.9％），기중간모세포류급신모세포류전이각1례。결론인동폐부병변이감염성병변위주；소우1세영유인칙이선천성폐지기관발육이상위주；악성병변발병솔저，단수주의여량성병변상감별。
Objective To investigate clinical and pathological features of lung lesions in children.Methods Clinical manifestations, radiologic imaging, histopathological features and immunohistochemical results were analyzed in 215 cases of lung lesions in children.Results A total of 215 cases of lung lesions in children aged 0 day to 13 years (average age of 27.2 months and the median age of 18.0 months) were selected, including 137 male and 78 female patients with a male to female ratio of 1.76∶1.00.The incidence of congenital lung disease was higher in patients of less than 1 year old than those of over 1 year old age, and the difference of the two groups was statistically significant ( P =0.004 ).142 cases had acquired lung diseases, and 73 cases had congenital bronchopulmonary dysplasia.Lung abscess was the most common lesion seen in 86 cases (40.0%) , including 1 case of fungal abscess.Congenital pulmonary airway malformation (CPAM) was the second most common, seen in 44 patients (20.5%), including 20 cases of type 1, 18 cases of type 2 and 6 cases of type 4 CPAM.Pulmonary sequestration was found in 25 cases (11.6%) including 14 cases of intralobar type and 11 cases of extralobar type.Two cases of extralobar pulmonary sequestration showed simultaneous CPAM2 type 2 lesion.Other lesions included tuberculosis (13 cases, 6.0%) , emphysema ( 12 cases, 5.6%) , interstitial pneumonia ( 7 cases, 3.2%) , pulmonary hemorrhage (6 cases, 2.8%), bronchogenic cyst (4 cases, 1.9%), bronchiolitis obliterans (2 cases, 0.9%), idiopathic pulmonary hemosiderin deposition disease (2 cases, 0.9%) and 1 cases of lung non-specific changes.13 cases of neoplastic lesions (6.0%) were found, of which 11 cases were primary tumors (5.1%), including inflammatory myofibroblastic tumor in 5 patients (2.3%), pleuropulmonary blastoma in 5 cases (1 case of typeⅠ, 2 typeⅡand 2 typeⅢ) and 1 case of mucoepidermoid carcinoma (0.5%) and 2 cases of metastatic tumors ( hepatoblastoma and Wilm′s tumor, 0.9%).Conclusions Infectious diseases are the most common lung diseases in children.Congenital bronchopulmonary dysplasia is the most common in children of less than 1 year old.Malignant lesions are rare.